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Preparing for patient education

To ensure our patient education success, pharmacists should prepare ourselves before providing patient education, including the knowledge, skills and tools. So, preparation is crucial part in patient education service. First, for patient education of medication use, educators should know some essential knowledge regarding pharmacotherapy, pharmacology, and dispensing pharmacy. So, pharmacists are the best educator of patient education. In clinical service, we use the online resources, such as Micromedex, Lexicomp or UpToDate. If your hospital could provide these database, you can easily search the useful knowledge in their patient education section. Otherwise, you could prepare several useful reference books in drug information center.
Back to the online resources, in Lexicomp, when you search a specific medication, you usually can find a patient education section at the bottom of the page. They even provide a printable ready-to-use leaflet in different languages for users to modify and print out to your patient. The content usually includes the indication of the medication, the short introduction of the disease, dosage, common side effects and precaution, and sometimes it include how to manage the side effects and recommendations about lifestyle modification.
The second preparation is skill. The skills of patient education are similar to communication skills. Pharmacists have to know how to communicate with patients so that we could provide an effective patient education. First, when we contact patient at the first time, we need to collect information from patients. The open-ended questioning and active listening are effective for obtaining information from patients, and also effective for sharing information with patients. During the first contact, pharmacists also need to know patient’s primary languages and seek some helps if needed, for example, you may need the interpreters. For different culture, pharmacists also need to adapt patients’ language skills. In Taiwan, most people can speak Mandarin, however, some people only speak local language, such as Minnan or Hakka.
So sometimes we need help from interpreters. In addition, we have more and more immigrates from other Asian countries, so, some hospital in Taiwan, they provide medication leaflets in different languages, including English, Japanese, Indonesian, or Vietnamese. Besides, pharmacists also need to observe and interpret the nonverbal messages, such as eye contact, facial expressions, body movement, and vocal characteristics. At the beginning, the nonverbal messages may be hard to observe, however, when you have more experience on patient education and counseling, you may know and easily observe some information from patient’s body languages. In addition, assessing a patient’s cognitive abilities, learning style, and sensory or physical status enables the patients to modify information and educational methods to meet the patient’s needs.
Other aids and tools may be necessary. For a patient who can not read, he or she may learn best by hearing spoken instructions, by seeing a picture or sample, or by directly handling medications and administration devices. In Taiwan, some elderly can not read, so we put some pattern on medication bags for better understanding. For example, a sun pattern means taking medication at day time, and a moon pattern means taking medication at night time. In addition to assessing whether patients know how to use their medications, pharmacists should try to understand patient’s attitudes and potential behaviors about medication use. So, pharmacists should try to solve the potential difficulties what patients did not tell you regarding medication use.
For example, antibiotics it should be taken on a fixed time interval, but patients may not tell you their daily routine schedule and they may skip one or two dose or prolong the time interval. Pharmacists should tell patients the serious outcome about antibiotics resistance, and try to help patients making suitable time schedule so that patients could easily follow the treatment plan. It is a simple example, however, many possible problems may happen in clinical practice. Pharmacists need to wisely solve patients problems and change patients attitudes and behaviors. But don’t be afraid, practice makes things better, when you practice more, you will be more wise to help patients.
In Good Pharmacy Practice guideline, it suggests that pharmacists should acknowledge patient consideration, such as education level and cultural beliefs, literacy, native language and physical and mental capacity. So, pharmacists should prepare their knowledge and communication skills about the local culture regarding the health and illness beliefs. Sometimes, the culture and beliefs may let patients hesitate to take medications. Let me take our experience in Taiwan as an example, people may go to the temples and prey for curing illness rather than seeking professional medical care. Another common culture is that the elderly likes to listen the radio programs about the healthcare, however, these programs often provide wrong information and often advertise medications that is unknown resources.
So many elderly, especially the elderly who living in rural area or who is low-educated, they take these fake medications rather than seek professional medical treatment. So, when our pharmacists provide patient education to community, we not only educate patients the correct drug information, we also often educate patients where to find the professional medical care and educate them that do not believe these medication advertisement and these radio programs. In addition, we provide the correct knowledge about disease and treatment.

Good preparation is crucial part in patient education service. Pharmacists should always prepare the knowledge, skill and tools before providing patient education.

Each patient is unique. A patient-centered education should consider patients’ culture, languages, cognitive abilities and medication history. Pharmacists should be able to identify the best way to educate each patient personally. In this video, Ms Chou used Taiwanese elderly folks as an example to illustrate the suitable approach one should take while undertaking patient education.

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Good Pharmacy Practice: Introduction to Medication Delivery Systems

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